ABSTRACT
The late radiation change observed in 15 patients treated for carcinoma of oral cavity or oropharynx using continuous hyperfractionated accelerated radiotherapy (CHART) was compared to that seen in 15 similar patients treated with conventional radiotherapy. The average follow up was, 31 and 33 months, respectively. A new dictionary for the recording of radiation morbidity, developed in our centre, was employed and proved highly satisfactory in the recording of the changes observed in these patients and also in a third group treated by a combination of chemotherapy and hypofractionated radiotherapy in hyperbaric oxygen. The dictionary was able to record all the morbidity clinically seen with these three treatment schemes. The late changes observed in skin and mucosa with CHART were similar to those observed with conventional radiotherapy, but hair regrowth was observed in six out of 10 men treated with CHART compared with persistent, partial or complete hair loss in all nine men treated with the conventional scheme; after CHART there was also a trend towards less taste impairment and less severe dryness of mouth.
Subject(s)
Carcinoma, Squamous Cell/radiotherapy , Mouth Neoplasms/diagnostic imaging , Oropharyngeal Neoplasms/radiotherapy , Radiotherapy Dosage , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/drug therapy , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Mouth Neoplasms/drug therapy , Oropharyngeal Neoplasms/drug therapy , Radiation Injuries/etiology , Radiography , Radiotherapy/adverse effects , Retrospective Studies , Time FactorsABSTRACT
Radiation morbidity is as important as tumour control when determining the value of radiotherapy, but there is no internationally agreed system for the recording of morbidity. A scheme based upon the scoring of the elements which make up morbidity has been endorsed by a 2-day Workshop sponsored by the Medical Research Council and a system is now available for trial.
Subject(s)
Neoplasms/radiotherapy , Radiation Injuries/epidemiology , Digestive System/radiation effects , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/etiology , Humans , Morbidity , Skin/radiation effects , Skin Diseases/epidemiology , Skin Diseases/etiologyABSTRACT
A previous survey of patients who survived more than 6 months after radiotherapy for carcinoma of the bronchus using a 6 fraction regimen revealed a considerable incidence of radiation myelitis. In a further survey, in which the data bank has been increased from a total of 303 to 754 cases, analyses have confirmed that radiation myelitis occurs once a threshold dose of 33.5 Gy to the spinal cord has been reached. The incidence was positively related to the hemoglobin concentration, but not to the blood pressure at the time of radiotherapy. In the same group of patients survival was positively related to radiation dose, the hemoglobin concentration, and the systolic blood pressure. In other patients who were treated with 6 fractions, but who received a lower minimum tumor dose, either because this was planned or as a result of cord shielding, no relationship was shown between survival and radiation dose, hemoglobin concentration and systolic or pulse pressure. Radiosensitivity is dependent upon the oxygen concentration which, in normal tissues, is related to the hemoglobin concentration and in tumor to both the hemoglobin and the systolic blood pressure. The achievement of a threshold radiation dose appears essential before these prognostic factors become relevant.
Subject(s)
Lung Neoplasms/radiotherapy , Myelitis/etiology , Radiotherapy/adverse effects , Carcinoma, Bronchogenic/blood , Carcinoma, Bronchogenic/mortality , Carcinoma, Bronchogenic/radiotherapy , Hemoglobins/analysis , Humans , Lung Neoplasms/blood , Lung Neoplasms/mortality , Prognosis , Retrospective StudiesABSTRACT
Analyses concerned with a group of patients treated by radiotherapy for carcinoma of the bronchus give evidence to support the view that oxygen tension at the time of radiation therapy is important both in determining tumor control and radiation morbidity.
Subject(s)
Hemoglobins/physiology , Lung Neoplasms/radiotherapy , Myelitis/etiology , Radiotherapy/adverse effects , Female , Humans , Male , Prognosis , Spinal Cord/radiation effectsSubject(s)
Antibodies, Viral/analysis , Measles Vaccine , Measles virus/immunology , Measles/immunology , Vaccines, Attenuated , Adolescent , Adult , Age Factors , Child , Female , Follow-Up Studies , Hemagglutination Inhibition Tests , Humans , Immunoglobulins/administration & dosage , Male , Measles/epidemiology , Measles/prevention & control , Melanesia , Middle Aged , Sex Factors , Social Isolation , Travel , VaccinationSubject(s)
Disease Outbreaks/history , Influenza, Human/history , Adolescent , Adult , Age Factors , Aged , Animals , Australia , Child , Child, Preschool , England , Female , History, 19th Century , History, 20th Century , Humans , Infant , Infant, Newborn , Influenza, Human/epidemiology , Influenza, Human/mortality , Influenza, Human/veterinary , Male , Middle Aged , New Guinea , Pneumonia/mortality , Sex Factors , Swine , Swine Diseases/epidemiology , WalesSubject(s)
Antibody Formation , Splenomegaly/immunology , Adolescent , Adult , Antibodies, Bacterial/analysis , Antibodies, Viral/analysis , Antigens, Bacterial , Bacterial Proteins , Female , Flagella , Humans , Immunoglobulin A , Immunoglobulin G , Immunoglobulin M , Influenza Vaccines , Lymphocytosis/immunology , Male , New Guinea , SplenectomySubject(s)
Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Adolescent , Adult , Aged , Australia , Child, Preschool , Chronic Disease , Evaluation Studies as Topic , Female , Geography , Humans , Immunization Schedule , Infant , Influenza, Human/epidemiology , PregnancyABSTRACT
Promising results have been obtained with vaccines prepared from influenza virus disrupted by treatment with desoxycholate. Trials conducted in Australia among children showed that desoxycholate-split vaccine caused no untoward reactions, even when administered in relatively large doses; similar results were obtained in adults. Methods for the large-scale production of such vaccine have therefore been developed in Australia.During 1969 over 6 million doses of desoxycholate-split A2/Hong Kong vaccine have been administered in that country, which was reached by the Hong Kong virus variant in August 1968. However, planned field trials with this vaccine have been of little value because of the limited nature of the influenza outbreak in Australia as a whole. Nevertheless, the vaccine does appear to have afforded protection in a widespread outbreak among the aboriginal population of central Australia caused by a second wave of Hong Kong influenza.
